Why You’re More Qualified in Suicide Prevention Than Most Mental Health Professionals
Yes, you just read that correctly. I’m Jeff Yalden and I’ve been working in Teen Suicide Prevention and Suicide Prevention – Teen Mental Health for nearly 30 years.
You’re about to read the lack of suicide prevention training our mental health professionals receive that is mandated or suicide prevention training our professionals are taking that is on their own time and money.
You’re about to understand how within minutes you, whether you’re a mental health professional, a parent, an educator, coach, pastor, or a friend can save the life of someone showing suicidal ideation.
Suicide Prevention in teens and adults isn’t rocket science when saving a life of an individual who is showing signs of suicidal ideation. In suicide prevention, what you do in the very early moments of crisis can save a life and prevent a forever decision.
For more suicide prevention training for your school community, click here!
Unqualified in America for Suicide Prevention, Yet Trusted with Suicidal Ideation Crisis Care
In February 2015, I spoke two days in a community that had 9 suicides in one year, including four in six weeks. Since my visit, they haven’t had a suicide.
“The Jeff Yalden legacy will live on in our community for years to come.” – Brett Boggs, Retired Superintendent, Akron, IN
We need more school based suicide prevention training for staff and students. (Click Here for more training).
Another day in a school community addressing students, staff, administration and meeting with counselors and having to do a suicide assessment of a teen only to send them to the emergency room to be evaluated by a medical professional who isn’t qualified. Another day where I am left disappointed, discouraged, but still hopeful. I will not give up on the broken system. I will not allow myself to cave into a system of professionals where I hear, “Jeff, I don’t know what to do!” If I do allow myself to accept this than I am as much a part of the problem as I am the solution and I can’t live with myself knowing that I gave up on people when for the past 30 years this has been my work and love.
Our Mental Health Professionals are overwhelmed and Receive Little Training in Suicide Prevention
Time and time again, I am working in a school as a youth mental health motivational speaker. After my talk, I work with the counselors to visit with students and sometimes staff members that want to talk. Sometimes (more often than you can imagine), a person comes with some serious suicidal ideation and sometimes homicidal ideation. The checklist is checked off and I’ve confirmed with the individual they are clearly at-risk of making the forever decision and knows they need help. I always want the individual person to take ownership and want help rather than forcing the need for help.
Most schools have a policy that if an individual is suicidal the parents or
guardians are called and asked to go to the emergency room or a 3rd party mental health professional and have a suicide assessment done before returning to school with a safety plan. I don’t like the word safety plan either. I prefer to call it a success plan.
This is not suicide prevention sending a student to the emergency room.
The issue with this is that when an individual leaves the hospital they’re not required to share with the school counselors or administration what the mental health professional (the person doing the assessment might not be trained in suicidal behaviors or risk of suicide), has given as far as a safety plan for the individual returning back to school.
If you’re a parent or individual and you are more concerned with your reputation than your wellbeing shame on you. This is nothing to be ashamed of and you being safe and a plan of action to follow is in your best interest and will be supported by those that really matter. Your school counselors, teachers, coaches, and administration are trusted and significant adults who can give you hope, support, and encouragement. They deserve to be trusted in what you need and together we can find resources that can help the person in need of care.
At the onset of the issue, remember, a person in crisis needs someone to listen to them without being overwhelmed, judgmental, and/or trying to solve the individual’s situation or emotions in that moment. Just deescalate the situation and give hope.
We can all do that by showing we care and because you know the individual and you intervened or they have come to you I believe you’re more qualified than a person with no mental health suicide prevention training. 58% of suicidal people have had no record of mental health care treatment or been given a diagnosis. So, it’s concerning to me to send the individual who is already scared to someone they don’t know who isn’t even qualified to make an assessment many schools or workplaces require.
Therapy: Why are Therapists rarely Trained in the Prevention of Suicide?
We are constantly telling parents that if your child is suicidal take them to a therapist and yet outside of psychiatrists, the majority of mental health professionals have very little to no formal training in how to effectively treat suicidal individuals.
Why is Suicide Prevention so Complicated?
If a parent or school counselor doesn’t have the answers we say, “See a therapist,” but our therapists (too many of them) don’t have the answers either and this isn’t fair when it comes to the well-being of the person we send off for an evaluation.
Every campaign around suicide prevention and mental health awareness says the same thing, “See a therapist.” Or, “Reach out and ask for help.”
While I don’t disagree with saying, “Talk to someone” and getting people struggling with mental health related emotions or suicidal ideation to speak up and ask for help, my greatest concern is comes with some basic questions that need to be answered in our communities:
Are we sending these individuals (now with more anxiety and fear) to people who aren’t qualified and are overwhelmed now depending on the depth of the situation of the person in front of them?
Are we providing the adequate care and support in our responsibility to refer to person to the right professionals?
Why don’t we have more training available?
Are we helping or hurting the individual?
Specific suicide prevention training is not commonly offered as part of college curriculums, optional post-graduate training on suicide is limited as well. This training is costly and time-consuming and really interested to people who’ve had experiences with suicidal ideation in their pasts or have been traumatized themselves. Furthermore, I’d say as much as many therapists aren’t aware that they themselves even need the education.
I was speaking on teen mental health and suicide prevention in West Fargo, North Dakota in December of 2019. Very tough audience and I ended up asking a question and one of the counselors said, “We already know this, why do we need to be here?” My audience was the school counselors, school psychologists, administrators, and school resource officers. I was dumbfounded by the question from a school counselor. More education to understand teen mental health is not something we should shy away from or be so ignorant to think we already know.
More concerning, after I left the community, I got a message from the local mortician who had attended my evening talk. At some point, during the evening after my talk, a local young man who had recently graduated made a forever decision. The next morning the mortician came to work having to deal with the reality of the conversation the night before and the reality of a school counselor saying, “We already know this . . .”
We Already Know This . . . Why Do We Need to Know More?
If we already know this we don’t know it well enough and we need to know more. We need to want to talk more about mental health awareness and getting people to feel more comfortable speaking up and talking about their feelings. We need to educate people on being okay not being okay, but not being okay and not talking about it isn’t okay.
You are not alone and shouldn’t be ashamed. You matter and what you are feeling right now is most likely temporary, but nobody can help if they don’t know you need it.
Don’t Treat Problems You Don’t Know
This is an ethical standard in any profession but also should be common sense to any person who cares and is compassionate towards others. You don’t treat problems you don’t know anything about. You ask for help and do your research, but ultimately find the answer and do the right thing.
But, what is the right thing when it comes to the lack of resources and trained professionals for people who are showing signs of being suicidal?
One of my mentors and trusted clinical psychologists I’ve learned and continue to learn from says, “Everyday thousands of untrained service providers see thousands of suicidal patients and perform uniformed interventions.”
If your son or daughter needed individual and personalized coaching for their chosen sport you wouldn’t trust in a random person opening a storefront that says, “Individualized Coaching for Your Students Athlete.” No, you’d probably want to read some reviews, references, make a few phone calls, etc.
Then why is it okay that we are not qualifying our service providers with their care for others?
Is it training? Is it insurance? Is it the stigma? What is it and why are we allowing this when teen suicide and teen mental health is an epidemic that needs attention and the right resources to help our communities?
Stop thinking that you are sending (someone who shows suicidal ideation) you care about to a therapist and because they’re a therapist, they’re skilled in how to address the risk of suicide. Nothing is farther from the truth and we could be making matters worse. Essentially, not helping but hurting the individual further.
In 2019, numbers of completed suicide had risen just slightly from the year before, but still statistics aren’t accurate because drug overdoses and accidental deaths; who says they weren’t suicide attempts. Nonetheless, since 1999, the suicide rate has climbed to a little more than 35%. This continues to be very concerning and deeply troubling especially to me when I work in consulting with school communities and mental health every day.
Finding a Therapist if you’re Suicidal
The training for mental health practitioners who treat suicidal patients – psychologists, social workers, marriage and family therapists, and others – is dangerously inadequate.
Combating suicide requires a holistic approach that includes the community, families, educators and our religious leaders all working together. The challenge is in society who has placed the burden of caring on suicidal people on a mental health workforce who is underprepared to help those in suicidal distress.
Mental health professionals have no national standards that require them to be trained in how to treat suicidal people. Whether it’s during their undergraduate work or during their career they are not required to get training or to be trained in suicide prevention. For the most part, they have to want to pursue training on their own or if they do get training it is limited and not consistent on a regular basis with more information and continued education credits.
Currently, only a handful of states mandate training in suicide assessment, treatment and management for health professionals, according to the American Foundation for Suicide Prevention.
Having someone on your side that gets what you’re going through, that can advocate for your needs, and that gives you the space to talk through your thoughts is a game-changer.
We have these trusted professionals within our communities. We have them within our schools. They’re called teachers, school counselors, coaches, parents, and friends. Peer to peer relationships matter. Relationships between adults and our children matter. Here is where it can be deescalated and hope given in the here and the now which puts time between a situation that triggers emotion and the possibility of a reaction on emotion that could be a suicide attempt or a suicide succeeding.
Within our schools, our trusted teachers, coaches, and counselors are more than qualified to listen and be a source of hope to the person who may be suicidal. But, if we quickly send the individual off to someone they don’t know we are making matters worse as anxiety increases and their unhealthy thoughts continue to think, “Nobody cares about me.” We can’t allow this to happen.
Teen Mental Health is Different Today Than Ever Before
Two questions need to be answered:
- Can I trust you?
- Do you care about me?
Whether it is a child, young person, or adult I believe these questions prove to the person in crisis they matter and there is hope. Remember this next time you are talking with someone.
The American Psychological Association and the Council on Social Work Education, which accredit graduate programs in psychology and social work, have standards to prepare graduates to treat patients in crisis but do not require specific competencies regarding suicide. This needs to change and perhaps be more of a requirement, but then again, who is qualified to teach such a course if very few of our professionals are even qualified themselves?
A report from 2014 on guidelines to improve training among the clinical workforce, the National Action Alliance for Suicide Prevention assessed the state of education by sending surveys to 443 academic institutions. Of those, 69 responded, and 70% said no specific training for suicide was provided.
Why out of 443 educational institutions did only 69 respond? Of the 69 that responded did 70% say they have no specific suicide prevention training is provided? Why is this acceptable? Who is stepping up to the plate in our schools across the country to say, this needs to change? This needs to be addressed and on my watch I am going to make sure our students, staff members, and families know we care about them all.
I am blaming it on us all because we are either part of the problem or we are part of the solution to a better world where we are safe and bringing up great leaders.
I work as a mental health motivational speaker and educator providing education and hope to school communities all over the world. I don’t get applause. In 30 years, I haven’t received a medal or a trophy for my work. Occasionally, I get the, “Oh, your work is so needed.” Or, “You must be so fulfilled knowing how much a difference you make.” Yeah, that is nice, but why can’t we all not be afraid to talk about our stories and to speak more openly about mental health? Why are we living with shame knowing that if people know we might be looked at differently and judged?
This is a conversation that needs to happen in every household in every community and every school district, but it shouldn’t have to be the full responsibility of our schools and the great adults that inspire our youth every day.
We need more parents parenting and being involved and invested in their kid’s lives and the family unit. We need less parents wanting to be friends with their kids. We have responsibilities as parents to raise our kids in a family that loves and unconditionally is supportive and caring for their needs.
Suicide Prevention: Nothing Changes if Nothing Changes
The American Association of Suicidology paper written in 2012 cited decades of studies that underscored the training gap in suicide prevention, and many experts say not much has changed in the last several years since this paper. Another concern not addressed and given more attention.
This paper stated that about half of psychology students receive formal classroom training on suicide during their graduate education. Only 25% of social workers receive any suicide prevention training. Marriage and family therapists had even less training. Most psychiatrists receive some instruction, but many experts agree it’s insufficient.
Talking about suicide shouldn’t be a difficult conversation and make a professional feel overwhelmed in the moment. Actually, this conversation is reducing the anxiety of the individual in distress because they’re talking and you the professional, you’re present and giving hope as you allow them to share what they’re feeling.
How you proceed from here is what concerns me and I am very concerned about how our schools have written policies and procedures for a student showing strong suicidal ideation.
Yesterday, I’m speaking at a school in Indiana. I’m with a school counselor counseling a senior who was 18 years old. This individual had every reason to be concerned including blacking out and being bloody, even from the night before. Scared to be alone. Every method of self-harm present on the daily including self-medicating, reckless behavior, banging head against the wall, cutting, and so much more.
As we called the parent after giving the student a choice; I said, “Either I have to call your father or the police, what do you want?”
Dad came in and we suggested what he should do, but no insurance.
At the end, I deferred it to the counselor because this was now a school policy issue. Can the student return to school with or without an assessment at this point? That was my question.
The counselor allowed the student to go with dad and nothing was going to prevent this student from returning tomorrow to school. No written note. No safety or success plan. Conversation had and off to go home to dad who this person stated was part of the problem they were having – abusive.
I had a talk with administration, head of guidance, and school resource officer after school. I had mentioned this is a gray area in school districts throughout the country. I said, “What do you think about this? What do you think you should do?” The head of guidance looked at me and said, “Jeff, I don’t know what to do.”
I am sorry, but you’re the head of guidance and you don’t know what to do is not acceptable and in my opinion if you’re over your head then you need to ask for help and put together a committee to assess the situation, rewrite the policies and procedures, and have a plan of action including what to do in the event of a student or staff suicide.
If you don’t do anything than nothing is going to change. Be the change and help give resources and support to your students and staff in need. That is our responsibility along with being mandated reporters.
School Safety Plans and Written Policies and Procedures for Suicide and Mental Health
There is a lot of talk about school shootings and what to do in the case of a shooting on campus. We have great security now with doors locked, visitors signing into our schools and providing their license, metal detectors, and more. We’ve done a great job protecting our schools, but we are failing on protecting our students and staff with mental illness.
If you are a school superintendent or building principal you have a responsibility to visit your students success manual and make sure you have written resources, policies and procedures that show your schools policy for mental health and suicide prevention. Not only the students and staff need to know what to do in the event of care or crisis, but also the parents need to be able to access this information.
This information needs to be accessible and easily found. It should be on the school website under resources, it should be given out in newsletters, and resources should be accessible in the main office, the counselors offices, the school resource officer, and the school nurse should all have copies they can share or email at moments notice.
Do not wait till after the fact where you end up having to do it out of necessity. Do it now and be proactive so that in the event, you can say you’ve done your best and continue to learn how to serve the wellbeing of your students.
This is a great responsibility to school administration and our elementary, middle schools, and high schools. This is also information that our colleges and universities should adhere to as well. As a matter of fact, I strongly believe that our state department of education in all 50 states around the country should mandate revised policies and procedures for all our schools with required mental health and suicide prevention training available for all staff and students annually.
Check out Jeff Yalden’s Suicide Prevention Course On-Demand for School Communities (Click Here).
Psychiatry and Suicide Prevention for Suicide Ideation
If you ask me, “Jeff, what should I say to a student, friend, family member in crisis?” My first response is to get this person to a trusted adult that they have a relationship with. Someone they trust and respect immediately. From here, let’s talk about professional help with your family doctor, therapist, counselor. Definitely take immediate action and take all signs seriously.”
You don’t want this person alone. In the moment of crisis you want to de-escalate the situation immediately. Put time between the thought and an action based on emotion.
Then, I’m concerned because I want to say, “Get to a psychiatrist as soon as you can.” But, I know that is usually a 4-6 month wait. We only have about 3700 psychiatrists in the country. Not nearly enough to address the mental health crisis our country is facing.
We only have about 3700 psychiatrists in the country. Not nearly enough to address the mental health crisis our country is facing.
I say a psychiatrist because they’re the only ones that are supposed to cover the topic of suicide during their training and course work.
Sending a person to a psychiatrist gives you some assurance that they know something about it, but you can’t say that for any other mental health professional and that is concerning to me when I am seeing the seriousness of mental health in our schools.
The burden that mental illness is placing on our educational system and our educators is too much and without proper training they’re over-whelmed and burnt out.
Advocating for a Person who is Suicidal
If you choose to wait the 4-6 months to get into a psychiatrist you are taking a calculated risk and are not putting the need for immediate attention to the matter. I highly recommend you don’t wait. Get on the list, call your family doctor, social worker, therapist, or whomever immediately and start the process. It’s the best thing to do in the moment and it’s working towards the care needed. Do everything you can to advocate for yourself, your child, your students, friends, family member, or neighbor.
Know this though, many of suicidal people have great experiences with therapy. Some of the therapy didn’t go well for one reason or another. While some therapy may have been lifesaving.
For those living with mental illness, therapy is like bathing, it should be routine and consistent. Maybe not as consistent as bathing, but depending on where the individual is it could be weekly, bi-monthly, and every two to three months when we know the once suicidal person is doing better and we trust they can do the work they’re required to do for their self-care and wellbeing.
“Having someone on your side that gets what you’re going through: feelings and thoughts, that can advocate for your needs, listen to your heart, and advise you without being judgmental and validating your feelings; someone that gives you the time and space to talk through what you are feeling and thinking is a total game-changer to the person in crisis.” This half-an-hour or hour can be what saves the life of a person that is suicidal.
Who is capable of giving a suicidal person this is any trusted adult, friend, teacher, counselor, school administrator, coach, or parents. As Doctor Phil says, “The most trusted adult in a child’s life is that same sex parent.” I agree, but to those young bloods that don’t feel comfortable talking to their parents, I believe any trusted adult in the child’s life can be that source of hope and support.
All these trusted adults that work in our schools need to know how to talk to a student in crisis or a student showing signs of suicide. Our teachers and any person hired by the school to work with students should also feel comfortable and capable in these moments of crisis.
Learning how to be this significant adult in a child’s life isn’t hard, but it’s not being mandated and the fear of addressing it because of the lack of training and knowledge makes today’s school administrators avoid rather than want to learn.
Be the voice and presence that shows a suicidal person they matter and you care.
Take Jeff’s Course on Teen Suicide Prevention . . . Available for all Staff, Teens, Coaches, and Support Personnel (Click Here)
How to Make a Suicidal Person Feel Less Suicidal
Contrary to what you might believe, most people living with suicidal thoughts say that when they found the right person or therapist, clinician or doctor, coach or teacher, someone who didn’t overreact and who made an honest effort to understand their pain, they felt less suicidal.
Less suicidal and the situation in the moment was de-escalated because this person sat down judgement free and listened in the space that made the person feel safe and heard. Before anything else matters, this is a moment that a suicidal person needs.
Whomever this person is, understand that they have their best interest at heart and cares more than just keeping you alive. This person, who probably knows the suicidal person whereas a therapist or emergency room doctor doesn’t, wants to help the person in crisis find a life worth living and to be there while they’re having trouble in the here and the now coping or problem solving though something they might think is the end of the world.
Be present. Be the light in the moment they feel so much darkness. Deescalate and listen with an open heart that shows you care and you want the best for this person.
I love working in education. I love our teachers, counselors, coaches, administrators and parents. I love speaking on mental health in schools and want every adult to know that you don’t need to be scared because you think you don’t know how to help. Know that the student in front of you doesn’t want to die either. They want a reason to live. They want to know they’re not alone and that someone cares as they share the burden or disappointment they feel.
Today’s youth especially, I strongly believe they don’t want to die. One of the issues I see is that today’s youth live so in the here and the now that when they have a problem they think it’s the end of the world. They see that the solution to their problem can’t be handled in the here and the now, but it might take time; days, weeks, months, or maybe this has ruined their life.
Life is not in the here and the now. Mistakes happen. It’s how we grow. Our youth need to know that perfection doesn’t exist and it takes courage to make a mistake and regroup. We grow from our mistakes and what we go through. Nothing is the end of the world.
Parents, teachers, educators, counselors, coaches and youth pastors are more than capable and qualified to help a person who may be suicidal, but know that you still have a responsibility not to leave the person alone, but to know what you should do now. It’s not over and you don’t want to leave the person alone.
A Suicidal Situation De-Escalated What Now
Breathe and know you did a great job and possibly saved a life. Also, let the individual know you are proud of them because it took a lot of courage to share and talk.
If it’s a child the parents need to be contacted and suggest resources of mental health professional care from this point forward. Work with your school counselors to have a success plan and get this student on the school radar where they’ll have support and care.
If it’s an adult contact the immediate family or significant other. Same thing, have resources available and encourage them to follow through for the best interest of the person in distress.
90% of the underlying factors to someone who is suicidal and showing suicidal behavior is mental illness. This mental illness comes in the form of anxiety, stress, overwhelmed, too high of expectations, coping, problem solving skills, depression, bi-polar, or something else that may have or even has been diagnosed.
You can always go to the emergency room or call 911. You can always call the Suicide Prevention Hotline at 800-248-2781 or Text 741741. These are definitely places to turn to, but know that in the moment, YOU knowing the person eases their anxiety and calms them down and the sacrifice on you is just time and patience. You have a better chance in the initial moments and if you’re feeling over-whelmed contact someone immediately for help and/or you can call the Suicide Prevention Hotline with the person. Just don’t react. Don’t leave the person. You being there and showing you care and your calming presence does more than you can imagine. I believe in you and the value you can bring to this moment.
Therapists are Lost when it comes to Suicide and Prevention
Imagine this for a moment, a suicidal person meets a therapist and what do you think they’re expecting? They’re expecting the person sitting across from them wants to understand their suffering. That is not the case, at all.
A more common feeling amongst therapists, counselors, and trusted adults is the moment they realize their sitting with a suicidal person is panic and they go from fight to flight themselves.
Now the panic is that the individual might try to kill themselves and could succeed and would they get sued or as a therapist maybe lose their license. The go-to all too often is to send the suicidal person to the emergency room.
You have this person who has come to you, but more than likely doesn’t want to die, but they don’t know what else to do and they’re desperate for help. Perhaps it’s taken days, weeks, months, or even years to have the courage to ask for help from a professional or someone and now this professional is saying, “I can’t help you. You have to go somewhere else. Like the emergency room.”
That can be very harmful and discourage the suicidal person further and give up.
Mental Health: Emergency Rooms and Involuntary Hospitalizations
Research shows that sending the individual to the emergency room or involuntary hospitalizations – triggered when a mental health professional believes someone is at imminent risk of killing themselves – can increase a person’s risk of suicide.
Here is where I want to encourage you to hold off and prioritize time and patience first. Then, focus on de-escalating the feelings and thoughts, and be able to get to a comfortable conversation where you can listen and offer support.
Here is where I am always successful depending on the severity of the situation. In the case of where I know the person needs a mental health assessment and probably a time out and a psychiatrist, I follow protocol, and I hate this because I know what happens. However, the point I want to stress is that I always communicate openly and honestly with the individual because if I am expecting them to trust me I need to be very open and honest in what is going to happen. I explain that this is what is right and in their best interest and I talk to them until they are on board and agree with what I am suggesting.
I do all of this after I have deescalated the situation and calmed them down a lot.
When the individual can have ownership and agree to the professional and mental health care they will take it more seriously, be honest, and be more willing to do the work. I never fail when I go this route. During this process, I am with them and sit with the person while parents are called and explain it through. If it’s a student who has a boyfriend or girlfriend or a really close friend, I will sometimes (with permission) bring the friend down so the person has their supportive friend with them. They never want to be alone. Remember, being alone feels to them they don’t have meaningful relationships and this support can be of incredible importance in their success through their care and afterwards.
Any person sent to the emergency room against their will and has psychiatric disabilities or mental illness, having had trauma, or is in crisis, this can be a trigger that could be the straw that breaks the camels back.
The emergency room can be the worst place for a person who is suicidal.
The emergency room is loud, patients are hurried in and pushed out with little to zero emotional support and maybe care.
There is no training, for the most part, for the emergency doctors, or the nurses to help a person showing suicidal ideation and having a plan.
Can you imagine?
But this is where we are sending our people in great distress.
It’s like, “I don’t know what to do so let’s send them to the hospital where it’s better than my help, because I don’t know what to do and I’m panicking.”
No.
You don’t send your car to someone who isn’t a mechanic. You don’t get a manicure or pedicure from a foot doctor who knows how to measure your feet for orthotics. We don’t bring our dogs to people who specialize in cats. We don’t make fancy dinner reservations at a breakfast joint, right? Come on, man.
The Suicidal Person Needs Two Questions Answered
Do you care and are you showing it? Great. Don’t panic and react. You are meeting the individual where they expect you to be even if you are not qualified.
Can I trust you and are you giving the time the individual needs to calm down and get help?
Great job. Breathe. You’ve done good. Now, we can move forward in a calm manner.
Look, even if the therapist doesn’t panic or over-react, that doesn’t mean they know what to do next or how to help.
I remember once, I was working with a school therapist hired by the school at $500 a day – four days a week. Yes, you read that correctly.
While working with a student who had suicidal ideation this therapist made the student “promise” that he/she would never do anything to hurt herself.
What? Really?!?!?!
That in principle is great, but if it were that easy the person wouldn’t be coming forward asking for help.
As the very last resort, the very last resort, you can make the person sign a document that you both create, like a contract, that says, “I will be here tomorrow. I will not make any decisions based on emotions. I will make the phone call (lists phone numbers) if I feel unsafe.”
At the very last resort you can do this. Exhaust everything before this becomes the go-to.
Remember, you are de-escalating the situation with someone you know more than any mental health professional who isn’t trained in suicide prevention who will probably do something that is worse than your kind heart and caring soul.
Don’t Kill Yourself, but WHY does the Individual Want to Die in the First Place
Don’t react to them wanting to kill themselves. Try finding out why they might want to die first.
In all my suicide prevention training in schools, I find our educators avoid the conversation and question of suicide all together. I also find with therapists and counselors the same thing.
Ever notice that when suicide is mentioned or mental health is being talked about the conversation gets really quiet? Yeah, because of the stigma and shame associated with the topic of mental health or suicide. Let’s change it and change it immediately. These conversations can be uplifting and doesn’t need to be talked about with shame.
I ask in my suicide prevention training programs in schools what the fear is about asking a student if they’re thinking about suicide. I come straight out and ask everyone. The most common answer is, “I’m not qualified to help them.” Or, they say, “If I ask them and they say, ‘Yes. What do I do then?”
Imagine this, many therapists have dropped clients who’ve been suicidal in the past because they’ve felt they were unable to tolerate the intensity of their pain and desire to want to die. Pretty concerning. Again, the time it had taken to reach out and ask for help and then they’re being dropped.
Some advice after 30 years of working with students and schools and addressing mental health and suicide in teens is that you can be compassionate and empathetic, but you can’t carry their darkness. Be present and engaged and show your love and support, but at the end of the day, you have to not carry the burden of this all being on you and you being responsible for them staying alive.
Another problem with mental health professionals and therapists is they’re so fixated on trying to predict how likely the individual is to kill themselves that they’re not present and listening as they should be. We’ve got to commit to spending the necessary time, patience, and listening to why they are hurt or feeling the way they’re feeling. Listen to what they’re asking. Listen to what they need.
A person who is suicidal is trying to share the depth of the pain in their heart – the depth of their despair.
This doesn’t necessarily mean they’re suicidal. It could mean they don’t see a way out or that they have to take this situation one day at a time. Let them know it will be okay and this is not the end of the world. Patience in the process. Perfection doesn’t exist.
We waste too much time trying to stop the person from killing themselves instead of finding ways to understand why they might want to die in the first place.
Do You Want to DIE?
That’s the question that tells you what you need to know, but too many people aren’t just afraid to ask this question, THE DON’T KNOW HOW TO ASK THE QUESTION.
I’ve visited and worked with more schools than I can count that have hired me after a suicide or multiple suicides.
One of the first things I want to know from a teen suicide is what they’re doing at the school in terms of suicide prevention or mental health awareness for their students and staff. Most of the time, I hear, “Well, that’s why you’re here. We need to start having the conversation.”
What I know is that we are a society of people who don’t know how to treat people who are suicidal. We don’t know how to ask the suicide question and we are afraid to ask.
When I do my teacher suicide prevention training and talk teen mental health I’m very proud of not having had one suicide after my visits to these school communities.
I praise and validate the importance of teacher and student relationships, school culture and climate, and giving these adults the tools to address their students who might show signs of distress and how to intervene on their level and to answer the questions that their students are struggling to even understand themselves.
Remember, you’re a teacher, a coach, parent, aunt, uncle, school nurse, or whatever you do. You are a good person. You are good-hearted and you’d be crushed if one of your students ended their life and you’d look back saying, “If I only knew, I could have said something.” Remember, you can’t carry the burden. Also, how are you supposed to know the individual was hurting if they’re not willing to talk and share?
Start the conversation before the crisis happens. It’s imperative our school communities start addressing teen mental health more openly and regularly.
Every day is an opportunity to say something meaningful and impactful. Let’s not wait to when we feel they need to hear our words.
Wouldn’t it be great if we were all kind and showed love to everyone each and every day? It’s the smiles, gestures, and the kind words that make a difference. It’s being compassionate, nonjudgmental, present, engaging, and seeing the best in others that makes a difference.
I’m not concerned with you assessing the situation and managing the risk in front of you. I just want you to know you are more than qualified to show your heart to someone else and let them know they matter while putting time between the now and what could be a forever decision.
Visit Jeff Yalden’s On-Demand Suicide Prevention Course for School Communities (Click Here)
This is a Teen Suicide Prevention On-Demand Course for all school staff and even teens that should be mandatory in every school. When we are not pro-active we become forced to be reactive and if you haven’t lost a student to suicide you don’t want to have to go through that.
The Big Picture of Suicide in America
Mental health professionals see suicidal patients throughout their careers and some very often, yet so few mental health professionals seek specialized training on suicide prevention.
If mental health professionals do want training it can be hard to come by especially if you live in rural North America, but I don’t agree that is the case. Some of the best therapies aren’t available for training in small groups, and those that are, require a lot of time and money. That prevents many from getting more education around suicide prevention. Again, I think that is an excuse and the lazy way to look at it.
With the technology we have today, education is basically free. Let’s not confuse memory with intelligence. You know what you know, but you don’t know what you don’t know.
If you really cared and wanted to educate yourself to be more of a source of help for your clients or students you can make a commitment to educate yourself by reading books, taking courses, google, and YouTube. With a little motivation you can invest in learning more without paying for it and waiting for training to come around.
Suicide Prevention isn’t mandatory for our professionals and I find that very sad and disturbing.
One of the most effective approaches to treating suicidal patients, CAMS – Collaborative Assessment and Management of Suicidality, says that in the absence of training, many clinicians spend most of their time trying to treat a patient’s underlying mental illness, rather than asking the person, “What makes you want to kill yourself?”
A teenager for example, why are we diagnosing teens when their brain isn’t fully developed and given all the hormonal, emotional, psychological, and physical changes; and social media today with overwhelmed feelings, expectations, and so much more; don’t you think it’s better to treat the symptoms and not look for the causes right now?
Get to know the individual and listen to their heart.
The two questions our youth ask today is:
- Can I trust you?
- Do you care about me?
They don’t come home from a long day and say, “Mom and dad, can we talk?” No. They come in the house get to their room as fast as possible and continue to isolate themselves where they’re comfortable and they only wish you’d come through the doors asking, “Honey, how was your day?”, being nonjudgmental and present.
Suicide Prevention Data from Center Disease Control and Prevention
In 2018, Center Disease Control and Prevention published data stating 54% of people who died by suicide had no known mental health condition.
Too many people are living with mental illness but not doing anything about it. Is it the stigma? Is it the shame and embarrassment? Is it being stubborn? Could it be the lack of resources available or the length it takes to get an appointment? Or, it’s the lack of trust in mental health and the feeling that we’re over medicating people? It’s all this and more, but regardless if you are going to live a healthy life living with mental illness you have to be your best advocate.
It starts with acknowledging the fact that you have a mental health condition you have to accept and choose to educate yourself. Don’t be the victim. Choose to be the victor. Don’t be bitter. Choose to be better.
What I am saying is very few people are trained to understand the depth of people’s individual suffering and with lack of knowledge and the ability to reach people where they are with patience and non-judgement is a major problem we need addressed.
Mental Health Specialized Suicide Prevention Training Impacting your Well-Being
Most people don’t get that specialized training is important to your well-being as a practitioner and without specialized training helping your clients or students can significantly impact your own mental well-being crippling you and sending you on a leave of absence or a change of job profession.
I can’t begin to tell you how many teachers, counselors, school administrators, school psychologists are no longer in the educational field working with students anymore because of the second-hand trauma. Too many to tell and many of these people I am still in touch with today.
Counseling clients and students has to be done with compassion and empathy, but to not be carrying the burden of their feelings, thoughts, emotions.
You can’t own what they’re going through, but you can listen, support, and give hope by giving tools to cope and problem solve. You can support them on the brokenness they’re living with and how one day at a time they’re willingness to do the work themselves will help them come from where they are to where they need to be.
Ultimately, they have to do the work with the help of you and more professional help.
How Therapists are Hurting Their Clients and our Youth
Every day I hear how therapists are frightened of treating clients with suicidal ideation. They’re screening patients who they think are highly at risk because they don’t want to treat them. They’re scared and don’t want to carry the burden or the liability themselves.
Clinicians are also afraid of the liability, but the concern is far less real than most mental health professionals think.
Personally, I think if you are more concerned about the liability than you’re probably not in the right profession and really concerned about the mental well-being of clients who are trusting in you and your profession. Only you can answer that question.
If a family who is grieving the loss of a family member or their child brings about a lawsuit, most cases bringing a lawsuit against you are not successful. Facts are not always persuasive when the undesired outcome feels so catastrophic.
In the state of Colorado (which has one of the highest suicide rates in the nation) a mental health survey showed many do not think they need more training, but desire it, according to a 2018 article in the Journal of Public Health Policy.
It found providers reported being “generally pleased with their existing training and felt prepared to address suicide within their practice,” though 80% supported mandating suicide-related continuing education.
Continued Educational Training for Suicide Prevention Helps Therapists Care for Their Patients and Themselves
Too many therapists feel the overwhelming pressure when confronted with the immense amount of pain a suicidal person is feeling – wanting to help; but fearing they’re not capable.
In this moment between you the professional, teacher, parents, or clinician and the client think:
- The suicidal person is safe in this space and you are their light
- Breathe and be present
- Between their high emotions and taking action is time and what is important is you are putting space between them thinking and acting slowly reducing their anxiety and deescalating their emotions.
- Gain their trust and let them know and trust that you care.
You’ve just won and perhaps saved a life.
From here. Follow protocol and follow through.
With continued education you will constantly be taught new tools you can use, methods of deescalating the crisis situation, and gaining control of the situation.
Although you might think you know how to respond, continued training can always teach you more and reiterate what you already know validating your work.
Don’t discount the emotional pain this takes. No matter how professional and prepared you are with experience, remember, you’re a therapist because you’re emotionally sensitive and have a great ability to connect with people. Add the training to be even more of a sensitive person and now you’re put in a room with someone who has the kind of pain and despair and shows behaviors that put them at great risk of dying by suicide and it’s easy to lose your bearing.
Any training provided or training you get on your own only benefits you and your clients.
Suicide Prevention Training and Continued Education
Talking suicide and addressing suicide risk is not something that is a one and done kind of training.
This is such a difficult conversation emotionally with serious consequences that people are going to feel unprepared and ill-equipped if they are not engaged in an ongoing way.
Our schools are starting to do a great job of mandating suicide prevention in our schools, but they’re far from where they need to be. Once a year training isn’t going to solve and save lives. This conversation, training, and continued support should be at least once a quarter made mandatory for every person who works with teens.
Unless you yourself seek out your own specialized training and continued education, and most people do not get this or take it upon themselves, it will become painful for you and impact your well-being. I see it happening every day and it ends up ruining lives, careers, families, and takes time to come back from this trauma.
Consultation Team Managing Stress and Burnout
Another highly effective treatment approach for severe suicide risk is Dialectical Behavior Therapy and with this treatment approach there is a consultation team to help manage the stress and burnout of the therapists.
Why do we not have these consultation group meetings in all our professionals where people manage people having traumatic experiences or living with mental illness and suicidal ideation.
I believe this approach should be mandatory for all mental health professionals and mandated for law enforcement, our military, churches, first responders, firefighters, doctors and nurses, and school personnel.
We need to start talking and sharing our feelings so we can help one another with the traumatic experiences being dealt with day in and day out. Until the stigma is silenced and people start talking we are going to continue to see no improvement in our communities.
Personally, having dealt with school communities and teaching suicide prevention, and watched suicides happen, having someone to talk to is invaluable to my continued success working with teen suicide and helping our school communities save lives and helping after a suicide.
Having someone to talk to is a crucial part of one’s self-care. As therapists we need to heed our own advice. Take care of yourself first. Self-care. You can’t pour from an empty pitcher. Self-care is not selfish. You matter and your mental health hydration matters.
This work can be very isolating and lonely. Being able to hear from others and relate with their experiences can be so helpful and so healing in ways that exercise or date night can’t give you.
A System Broken – Nobody Cares
For years and years the system is broken and inadequate training has long been documented but nobody is changing the system or putting efforts where efforts are most needed.
We need to take teen suicide prevention and mental health more seriously in America and our schools.
Our government is putting millions of dollars towards the suicide prevention, mental health and the opioid epidemic, but who’s accounting for the money and making sure it is used effectively?
I believe that the money is giving a lot of people jobs with titles and cushy comfortable desks, chairs, and a nice corner office with a paycheck, but few people are on the ground doing the work. Too much delegating and forming of committees, but nobody doing the work we talk about in the meetings. Very sad. I see that everyone has the answers, but nobody wants to do the work.
Let’s stop all the talking and meetings and start implementing plans, procedures, policies, and trainings. Stepping up the suicide prevention game should be a priority for our government.
In my early days when I was just learning and starting my focus on mental health the National Strategy for Suicide Prevention said that it was critical that “mental health personnel receive appropriate graduate school training on the suicide while preparing for their professions.” This was back in 2001.
Twenty years later, experts say that not enough has changed. Not enough has changed and while we watch the suicide epidemic continue to grow we are still saying, “What are we doing?”
The answer is simple.
We are doing a lot of blaming and not enough talking and taking action.
Suicide Prevention Conversations Start at Home
It starts at home. Parents should not be diagnosing their children. Parents need to take all signs seriously and educate themselves on teen suicide prevention and mental health. This includes the dopamine effect from screen time, social media, and too much time in isolation.
It’s also in our schools. We need more teen suicide prevention and mental health support in our schools and also improve the relationships between our schools and our families. We’ve got to work together for the best interest of one another.
Our family doctors are not mental health therapists or teen suicide prevention physicians and shouldn’t be diagnosing or prescribing medication (long – term) for their patients. A family doctor could treat the symptoms for seven to thirty days, but make it clear that a mental health therapist and/or psychiatrist is essential to the wellbeing of the child. If you don’t believe in therapy or counseling, medication and such, also educate yourself on natural remedies such as exercise, nature, food, essential oils, meditation and being involved.
Therapy and medication is a game changer. Taken together is best. If it’s one or the other, therapy gives you tools to cope and problem solve while medication puts a band-aid on the illness.
Then, it’s the individual who does the work for themselves. Continued education on Teen Mental Health and Suicide Prevention, exercise, daily practice of self-care, learning mindfulness, breathing, and relaxing techniques to help you through your own emotions. Again, put time between the thought and the action is most crucial in the moment of crisis.
It’s okay to not be okay, but it’s not okay to not be okay and not do anything about it.
We can blame it on the system or we can take it upon ourselves. To blame it on the system solves nothing. To take responsibility and advocating for yourself, your family, your school is being responsible and you’re more likely to get something done and working. It takes a combined effort.
How We Can All Support Mental Health
Be open to talking more and engaging in conversation about suicide prevention and teen mental health. Continued education for your school and community is very important and will save lives.
The American Association of Suicidology has a report on gaps in mental health training and suicide prevention. They’ve made several recommendations for improving care. This is good and must be followed through state by state.
The report states that accrediting organizations must include suicide-specific education as part of their requirements so graduate programs have the training in their curriculum.
Also, state licensing boards, must require clinicians be competent in suicide treatment.
And the report also says government has a role to play by requiring that health care systems receiving state or federal funds ensure their mental health professionals are trained in suicide risk detection, assessment, treatment and prevention.
Other experts also say clinicians have to overcome their fear of not knowing who may live or die. Who is going to live or die shouldn’t be the thought in the middle of the open room where you are being trusted by this person asking for help. Be present and focus on the individual in front on you. Focus on deescalating the emotion and calming the situation. Create a plan of action and move forward. When this is our primary concern and before they leave your office you’ll know they’re feeling better and we can only pray they’ve been giving the tools, even if it’s only temporary, that they’ll take it one day at a time, but that they’ll also continue to seek help and receive treatment weekly.
As in all cases, if they’re in the middle of an emotional breakdown and considering suicide, make sure they have a Safety Plan such as 911 or go to the Emergency Room. They can call the National Suicide Hotline at 800-273-TALK (8255) any time day or night, or chat online.
The Crisis Text Line also provides free 24/7, confidential support via text message to people in crisis when they dial 741741.
There is great responsibility and I understand. You’re worried about your livelihood and your family, your license, and more. However, we have a responsibility to protect the person and give them what they need and that is your professional experience and training. We have to be able to see past the risk to do what is right for our patients and students.
Finding a Therapist with Suicide Prevention Specific Training
Look for a therapist who specializes in evidence-based suicide prevention techniques such as Dialectical Behavior Therapy, Cognitive Behavior Therapy for Suicide Prevention or Collaborative Assessment and Management of Suicidality.
I know you’ll be have a tough time finding this person who is specialized, but if you do, it’s a good lead for you. Not everyone who is trained is listed and not everyone who is listed is currently trained and up to date.
In certain cases of suicidal risk, being informed versus uninformed therapy can be the difference maker in saving a life or a death by suicide for someone who cannot bear their suffering any further. Job specific training is critical.
A well-intended and competent therapist who does not know how to effectively treat a suicidal person can result in the most tragic mental treatment outcome possible.
Finding a Psychiatrist and Make an Appointment Quickly
The profession of psychiatry (depending on where they go to school) requires psychology students receive formal education training on suicide during their graduate education.
The actual research shows that only half of psychology students receive this training.
Only about 25% of social workers receive any suicide prevention training.
Marriage and family therapists get even less suicide prevention training.
The exception is psychiatrists, most of whom get some instruction on suicide prevention.
Think about this . . . Suicide Prevention ten years ago is very different than suicide prevention today and with our youth.
“I’m Suicidal!” What should I do?
If you’re a patient, and you are suicidal, consider not saying so right away.
Here is why. The word ‘suicide’ can scare off a therapist even if they hear the word ‘suicide.’ Especially if they haven’t had adequate training to properly assess for risk, so they rush to involuntary hospitalization which in some cases make matters worse.
Research shows involuntary hospitalizations — triggered when a mental health professional or counselor believes someone is at imminent risk of killing themselves — can increase suicide risk.
When seeking a therapist who specializes in suicide here is some advice that can help you. When talking about suicidal thoughts always talk in the past tense, even if you’re currently living with them.
Here is an example:
- I’ve had suicidal thoughts in the past and I want to know how you approach that?
- What could I feel safe sharing?
- When do I need to worry you’re going to involuntarily commit me?
Slowly ease into full disclosure when you trust that you are safe with this therapist or counselor. I would also highly encourage these questions be asked during during a phone consultation or initial session.
Here is an example:
- “How would you handle it if someone disclosed suicidal thoughts during a session?”
- “What training have you had in working with self-harm?”
- “What are your thoughts about someone who dies by suicide?”
Having an initial session is for the therapist and also the client. The therapist
if the work is within their competency, and for the client to decide if that therapist is a good fit for them.
Even if someone doesn’t have suicide-specific training, it could still be a good fit.
It’s about the quality of the relationship that matters. It about a connection of trust, nonjudgment, and rapport.
Find a Buddy
Looking for a qualified therapist (suicide prevention) during a time when you’re suffering can be a significant emotional burden. Experts say it’s best if someone who cares about you is also part of the process, so you don’t have to navigate it alone.
If you’ve ever had suicidal thoughts: Make a Safety Plan
Don’t Despair
Choosing a therapist is a privilege many suicidal people don’t have. Some suicidal people can’t afford help. Many live in rural communities where there’s a limited amount of practitioners, or long wait lists for care.
If you don’t have access to the care you want right now, there is still help available:
- You can call the National Suicide Prevention Lifeline at 800-273-TALK (8255) any time day or night, or chat online.
- The Crisis Text Line provides free, 24/7, confidential support via text message to people in crisis when they dial 741741.
- The National Alliance on Mental Illness has support groups for people living with mental illness.
Mental Health Speaker & Suicide Prevention Expert, Jeff Yalden
On February 26, 1992 at 0738 in the morning, Jeff Yalden was witness to a Marine suicide while stationed at Cecil Field Naval Air Station, Jacksonville, FL.
This moment changed Jeff’s life. Thirty years later, Jeff Yalden is one of the leading experts on Teen Suicide, Suicide Prevention, and Suicide Prevention Training and Mental Health Speakers in the world.
He’s the author of Teen Suicide: The WHY Behind America’s Suicide Epidemic (Click Here). He is the creator of the OnDemand Suicide Prevention Course for School Communities: (Click Here).
Jeff is also the founder and executive director of The Jeff Yalden Foundation, Inc. (Click Here). The Jeff Yalden Foundation is a non-profit 501c3 organization that focuses on Teen Mental Health and Suicide Prevention in School Communities.
Jeff is also renowned as a teen mental health motivational speaker and mental health speaker. He speaks to teens, teachers, parents, and mental health professionals on teen motivation and mental health and mental wellness.
Personally, Jeff lives in Myrtle Beach, SC and loves the beaches, boating, yoga, and being in his Wood Shop, Wood Times. He’s a 200YTT Certified Yoga Teacher.
Contact Jeff if you’re interested in Jeff visiting your school community and speaking or doing a Teacher Staff Development Talk. Whether it is LIVE or on ZOOM, Jeff is always engaged and fun to listen to.
Visit: www.JeffYalden.com
